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A Comparative Pilot Study of Enalapril, A New Converting Enzyme Inhibitor, and Hydrochlorothiazide in Essential Hypertension
Author(s) -
FERGUSON ROGER K.,
VLASSES PETER H.,
IRVIN JOHN D.,
SWANSON BRIAN N.,
LEE ROBYN B.
Publication year - 1982
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1982.tb02676.x
Subject(s) - hydrochlorothiazide , enalapril , plasma renin activity , blood pressure , essential hypertension , medicine , combination therapy , aldosterone , pharmacology , urology , placebo , crossover study , endocrinology , adverse effect , renin–angiotensin system , angiotensin converting enzyme , alternative medicine , pathology
Eight patients with essential hypertension completed a double‐blind, randomly allocated crossover comparison of either 5 or 10 mg enalapril maleate, 50 mg hydrochlorothiazide, or their combination administered once daily during sequential two‐week periods. Blood pressure, pulse rate, plasma renin activity, angiotensin‐converting enzyme activity, plasma aldosterone concentration, and urinary electrolytes were monitored for 24 hours after placebo and on days 1 and 14 of each treatment period. After two weeks of each treatment, only the combination of enalapril and hydrochlorothiazide significantly lowered the mean seated diastolic blood pressure (SDBP). Likewise, SDBP control (≤ 90 mm Hg) was achieved only after combination therapy; six of the eight patients were controlled by the combination for up to 24 hours. The initial SDBP response to combination therapy differed with the sequence of drug addition; however, by day 14 the responses were comparable, regardless of whether hydrochlorothiazide or enalapril was first given. Mean converting enzyme activity was suppressed by enalapril in all patients, though it did not always correlate with changes in SDBP or plasma aldosterone. Mean plasma renin activity increased, but the increase was significant only on the combination. There were no serious adverse effects.